Department of Otorhinolaryngology, Mugla Sitki Kocman University, Mugla, Turkey.
Curr Opin Otolaryngol Head Neck Surg. 2022 Aug 1;30(4):260-264. doi: 10.1097/MOO.0000000000000809.
The purpose of this article is to review the recent grafting strategies in maxillofacial trauma.
Recent technological advancements have applications in the management of maxillofacial trauma; advancements in imaging modalities such as 3D imaging can help surgeons in both the preoperative and intraoperative periods. These may be coupled with navigational systems to further facilitate complex reconstructions. 3D printing has been used in reconstruction and 3D, 4D, and 5D bioprinting technologies continue to improve and to find new uses, and stem cells and growth factors in maxillofacial trauma are also among the most studied topics. Maxillofacial traumas have decreased in number during the COVID-19 pandemic, as more conservative approaches have been preferred in COVID pandemic conditions.
Preoperative planning is the most important step in the reconstruction of maxillofacial trauma defects, and early bone and soft tissue reconstructions are recommended in severe maxillofacial traumas. Autogenous grafts are the gold standard in bone grafting. Nonvascularized grafts are planned according to the size, shape, and location of the defect, with vascularized bone flaps preferred in large defects, wide soft tissue defects, and contaminated defects. Alloplastic grafts or xenografts may be used if autogenous grafts are not available.
本文旨在回顾颌面创伤中的最新植骨策略。
最近的技术进步在颌面创伤的治疗中有应用;3D 成像等成像方式的进步可以帮助外科医生在术前和术中阶段。这些可能与导航系统相结合,以进一步促进复杂的重建。3D 打印已用于重建,3D、4D 和 5D 生物打印技术不断改进并找到新的用途,颌面创伤中的干细胞和生长因子也是研究最多的课题之一。由于在 COVID 大流行期间更倾向于采用更为保守的方法,颌面创伤的数量有所减少。
颌面创伤缺损重建的最重要步骤是术前规划,严重颌面创伤建议早期进行骨和软组织重建。自体移植物是骨移植的金标准。非血管化移植物根据缺损的大小、形状和位置进行规划,在大缺损、广泛的软组织缺损和污染的缺损中,更倾向于使用血管化骨瓣。如果没有自体移植物,可以使用同种异体移植物或异种移植物。